State of the Union Address Gets Mixed Reviews

Opioid crisis discussion rings hollow to some

Reactions to President Trump's State of the Union speech Tuesday night were varied, with some saying it was all to be expected and others complaining about the lack of science in the address.

"The State of the Union is really a speech where they run the gamut on all the issues," said Julius Hobson Jr., JD, a healthcare lobbyist at Polsinelli, a Washington consulting firm. "I have a jaded view of [the speech] -- I don't care who's president -- and it's simply because of the nature of what the speech is."

The president's remarks about the opioid crisis -- that it's a serious problem and something needs to be done about it -- don't match up with his actions, Hobson said. "The administration declared opioids as a big issue and then proceeded to try to cut the budget [for the Office of National Drug Control Policy], and the next thing you know you've got a 24-year-old who got dismissed from his last job ... who has no idea about what he's doing and is now the most senior person in that office. That doesn't work." (The person to which Hobson referred, Taylor Weyenth, will step down Thursday.)

"I don't care what the stated policy is -- what are you spending your money on, what are you working on?" he said. Noting that the president also talked about locking up drug dealers, Hobson added, "When you talk the 'law and order' line, it makes it harder to deal with people who are addicts ... I thought we learned that lesson from the Clinton years; when you build prisons and lock people up, it doesn't work. Something else needs to be tried."

Robert Graboyes, a senior research fellow at the Mercatus Center, a right-leaning think tank, praised the speech's inclusion of so-called right-to-try legislation. "No aspect of healthcare reform is more important than enabling innovators to develop and distribute lifesaving drugs as speedily as possible -- especially for the benefit of those whose only chance at life rests on cutting-edge treatments," he said in an email.

"The President asked Congress to pursue right-to-try legislation at the national level -- a prudent and humane measure that would reinforce the ongoing state actions. As the president intimated, failure to take such action will encourage Americans to seek treatment abroad."

Overall, the speech seemed to signal that the Trump administration isn't going to be initiating a lot of legislative activity on healthcare, said Jocelyn Guyer, managing director at Manatt Health, a Washington-based consulting firm. It was notable that Trump "didn't say all that much about healthcare" in comparison to last year's speech, she added.

Guyer also was concerned that Trump's comments about repealing the individual mandate may confuse consumers. While it's true that in the long term the mandate will be repealed, "it's actually still in effect, including for 2018."

Like Hobson, Guyer also expressed concern about what the administration was doing in response to the opioid crisis, as well as high drug prices. "There's been a lot of concern and talk for a while. But the health policy community is looking for the specifics going forward. "

At least one science organization was not pleased with the president's failure to discuss science issues. "While the president outlined an aggressive plan for investing in the nation's infrastructure, the scientific community needs more support and leadership from the White House," Benjamin Corb, public affairs director for the American Society for Biochemistry and Molecular Biology, said in an email. "Countless scientific positions in President Trump's administration remain unfilled, and several others are held by non-scientists."

"Agencies such as the National Institutes of Health and National Science Foundation – critical funders of the nation's scientific enterprise – continue to grapple with budgetary uncertainty, which slows the pace of innovation and makes American science less competitive in a global environment," he added. "Advances in the life sciences will help citizens worldwide live longer, healthier lives."

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